Question

Mr. Lacey is a 72-year-old patient with

been stable for the past 10 years. His signs and symptoms
neck veins, and crackles bilaterally in the lower lobes of his
included: +1 bilateral lower leg swelling, visibly enlarged jugular
lungs. This morning he has a weight gain of 6 pounds over the
past 2 days, as well as increased shortness of breath. His
twice a day and furosemide (Lasix) 20 mg once a day.
1. What type of heart failure is indicated by Mr. Lacey's
symptoms?
2. What does Mr. Lacey's weight gain and increased
shortness of breath indicate?
3. What are the purposes of Mr. Lacey's prescribed
medications?
edding was
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4. What changes in Mr. Lacey's prescribed medications do
you anticipate and why?
5. What are key teaching points for Mr. Lacey at this time?

Answer 1

Step-by-step explanation:

Mr. Lacey's symptoms indicate congestive heart failure (CHF), specifically, left-sided heart failure. The visibly enlarged jugular veins suggest that there is an increased pressure in the veins returning blood to the heart, which can be caused by an inability of the left ventricle to pump enough blood out into the systemic circulation. The crackles bilaterally in the lower lobes of his lungs and +1 bilateral lower leg swelling suggest fluid accumulation, which is a hallmark of heart failure.

Mr. Lacey's weight gain and increased shortness of breath indicate that his CHF has worsened and he is experiencing fluid overload. The weight gain is likely due to fluid retention, and the shortness of breath is caused by the accumulation of fluid in the lungs, which makes it harder for him to breathe.

Mr. Lacey's prescribed medications serve different purposes to help manage his CHF. The lisinopril is an ACE inhibitor that dilates blood vessels, reducing the heart's workload and improving blood flow. The carvedilol is a beta-blocker that slows the heart rate and reduces the heart's workload, while also improving blood flow. The furosemide is a loop diuretic that helps to eliminate excess fluid from the body by increasing urine output.

Based on Mr. Lacey's worsening symptoms, it is likely that his prescribed medications will be adjusted. The dosage of furosemide may be increased to help eliminate the excess fluid that has accumulated in his body. Additionally, the dosage of lisinopril and/or carvedilol may be increased to help improve his heart function and reduce the workload on his heart.

Key teaching points for Mr. Lacey at this time include:

Following a low-sodium diet to reduce fluid retention

Monitoring his weight daily and reporting any sudden changes to his healthcare provider

Taking his medications as prescribed and not skipping doses

Recognizing the signs and symptoms of worsening CHF, such as weight gain, increased shortness of breath, and swelling, and seeking medical attention promptly

Engaging in regular physical activity as appropriate, such as walking or light exercise, to improve heart function and overall health.